Text4baby Program. Harnessing the Power of Mobile for Maternal & Child Health in the U.S. 6/16/2015

Transcription

1 Text4baby Program Harnessing the Power of Mobile for Maternal & Child Health in the U.S. 6/16/2015

2 Mobile Technology 89% of young women have cell phones 99% of text messages are read. 90% are read within 3 minutes People of color are more likely to text than their White counterparts Low-income Americans text more than higher-income adults 2

3 Text4baby Supports Your Work Text4baby is the largest mobile health initiative in the nation reaching nearly 900,000 moms (and in Michigan over 32,000 moms) since launch in 2010 and is available in all 50 states and the U.S. territories. Pregnant women and moms with babies under one sign up by texting BABY (or BEBE for Spanish) to Receive FREE health and safety messages three times per week timed to due date or baby s birthdate. Experts (CDC, ACOG, AAP, March of Dimes, etc.) review messages routinely to ensure medical accuracy. Reaches low-income and young women, particularly those who identify as Hispanic or African-American. Research shows that these women are at a higher risk of having disproportionately poor birth outcomes. Text4baby reinforces and supports ongoing education and assists with retention through critical messages and reminders: Signs of Labor Mom and Baby s Appointment and Immunization Reminders Healthy Eating for Mom and Baby Safe Sleep Urgent News (e.g. pertussis outbreaks. product recalls) Health Insurance Information Resource Hotlines and Websites Text4baby

4 Diverse Partners in Health Care Federal Agencies 50 State Health & Medicaid Agencies 96 Health Plans Major Health Assns. Hospital Networks Media Partners >50 State & Local Coalitions text4baby

5 Content Development and Messages text4baby

6 How Text4baby Works Mom texts BABY/BEBE to Mom gives due date/dob & zip code Mom gets free tips 3x/week throughout pregnancy & until baby s 1 st birthday Through Text4baby, moms can also learn more about certain topics; get support for enrolling in Medicaid/CHIP; take quizzes; get urgent health alerts; sign up for appointments, WIC meetings and vaccination reminders; provide feedback on specific messages; and get connected to support hotlines. text4baby

7 Text4baby Addresses Critical Maternal and Child Health Topics 267 Messages Total Messages by broad topic area: 61 Safety 56 Development 45 Nutrition 44 Support 30 Infectious disease 20 Health care access 18 Well baby visit 18 Symptoms 11 Screening 9 Prenatal care 8 Oral health

8 Smoking Cessation Breast Feeding Health Care Access Diabetes Nutrition Oral Health Immunization Prenatal Care Disabilities Family Planning HIV/AIDS Prevention Violence Prevention Physical Activity Safety & Injury Prevention Mental Health Substance Abuse Prevention Developmental Milestones Labor & Delivery Car Seat Safety Safe Sleep Exercise text4baby

9 Content Development & Review Literature Review Priority Topics Content Development Expert Review Audience Testing Ongoing Revision Audience Testing Text4baby s Content Manager -- who developed the American Academy of Pediatrics Bright Futures guidelines ensures accuracy, currency, and consistency with medical research and science. Content Development Council: American Academy of Pediatrics American College of Nurse-Midwives The American College of Obstetricians and Gynecologists Association of Women s Health, Obstetric and Neonatal Nurses Centers for Disease Control and Prevention Health Resources & Services Administration March of Dimes National Association of Pediatric Nurse Practitioners Society for Maternal-Fetal Medicine text4baby

10 Interactivity in Text4baby Service 58% contain additional health and resource info 46% (123 messages) link to Text4baby mobile webpages developed in partnership with major medical associations 25% (68 messages) provide a resource phone number 45 links to videos 15 visit & appointment reminders 6% of messages link to external websites 9 messages prompt mothers to text back LIKE when they find a message helpful 7 messages encourage mothers to text back MORE to get additional information 4 interactive user feedback and engagement survey questions (e.g. Did you ask your provider about a health topic covered in Text4baby? ) 3 interactive modules that connect moms to healthcare, remind moms of well-baby visits & immunizations, and encourage flu shot vaccination 2 quizzes (Food safety-pregnancy; car seat safety-infancy)

11 Improve Appointment Attendance: Use Text4baby Appointment Reminder Service Mom texts REMIND or CITA (Spanish) Prompts mom to text appointment date in mmddyy format (e.g., ) Prompts mom to text description (9 AM Vista DR office, bring lab results.) Text4baby participants can set up reminders for their appointments. (e.g. prenatal, postpartum, well-baby, dental, WIC, home visit) Moms and parents enrolled in Text4baby with and without smartphones can receive FREE text appointment reminders. Moms receive a reminder three days before and morning of appointment.

12 Dads Matter Father involvement is linked to positive cognitive outcomes for a child and father involvement in pregnancy is linked to a reduction in infant mortality. Additional messages were launched on Father s Day 2013 for expecting fathers and new fathers. Messages contain critical information and tips on how to improve child health and safety, ways to engage with your baby and how to support a mother s health 12

13 Text4baby Alerts Moms of Urgent Health News, Recalls, Outbreaks, etc. Tylenol recall, May 2010 Pertussis outbreak CA (CDC), July 2010 Similac formula recall, September 2010 Sleep positioners warning (FDA), October 2010 New car safety seat guidelines (AAP), March 2011 Deadly hot cars (Safe Kids), July 2011 Benzocaine warning (FDA), August 2011 Window falls prevention (AAP & CDC), September 2011 Warning about crib bumpers (AAP & CDC), October 2011 Carbon monoxide poisoning (CT & MA), November 2011 Warning about button batteries (Safe Kids), December 2011 CMS enrollment (CMS), February 2012 Medicine safety (CDC), March 2012 Pertussis - 7 states (CDC), April 2012 and 44 states (CDC), June 2012 Hurricane Sandy Refrigerated Food 12 states, November 2012 Health Insurance Marketplace & free/low cost plans (CMS), August 2013 text4baby: Would you like some support during your pregnancy or with your new baby? Home visiting supports pregnant women & families with kids up to age 5. Home visits can cover many topics, based on what your family wants. Learn more and find a home visiting program: E852Qd text4baby

14 Unique Features and Projects text4baby

15 Custom Text4baby Eleven states currently utilize a custom or tailored version of the Text4baby service, which includes: Local resources and services Information about how to connect to state-specific free and low cost health care. The ability to send ad hoc messages to state participants about recalls, new services, outbreaks, or other emerging information. These states are currently offering a custom service: California, Florida, Louisiana, Ohio, Oklahoma, Massachusetts, *Michigan, Missouri, Nevada, New York, and Virginia.

16 Interactive Opt-In Modules In addition to the general Text4baby protocol messages, the service includes 3 interactive opt-in modules to collect additional participant data, connect to specific resources and medical information, and respond to participant needs. 1. The Immunization Module reminds moms of well-baby visits & immunizations in the first year of life. 2. The Medicaid Module connects uninsured moms/infants to health coverage information. 3. The Flu Module encourages flu shot vaccination during pregnancy and motherhood during flu season and provides a coupon for a free flu shot through a partnership with Rite Aid.

17 text4baby

18 Text4baby App Complements Text Messages The interactive app offers information to complement the text messages Weekly developmental milestones through pregnancy and baby s 1 st year A weekly, timed planning list of medical, developmental, and lifestyle calendar items Polls that allow participants to see how they stand compared to other moms on topics such as pregnancy symptoms, infant development, and emotional experiences

19 Sign-up Integrated With Texts 1 9

20 Talking is Teaching: Talk, Read, Sing Partnership with Too Small to Fail & Sesame Street Enhance Text4baby messaging with an early language content development content stream Highlight how important it is for parents to talk, read, and sing to their children during everyday moments & routines. Promote videos and additional resources to model this behavior. Messages delivered every Wednesday when baby is 9 weeks old until they are 1 year-old. Visit and text4baby 20

21 Text4baby Driving Desired Outcomes

22 Text4baby is reaching individuals early in their pregnancy 39% enrolled during first trimester Text4baby is Reaching its Target Audience Text4baby is reaching women in high-poverty areas A higher percentage of Text4baby users live in zip codes with the highest levels of poverty compared to the overall U.S. distribution text4baby 22

23 Well Received by Participants 99% of WIC participants in an Emory University study (baseline n=468) had no concerns about enrolling in Text4baby; 95% reported the enrollment process was easy; 92% regularly read Text4baby messages; and 88% planned to continue to use Text4baby. 1 93% of participants who responded to a Text4baby survey said they would refer Text4baby to a friend (n=26,650) and rated the helpfulness of the service a 7.7 out of 10 (n=38,090). 2 The average satisfaction rating for Text4baby participants of the California State University San Marcos National Latino Research Center and CSUSM/UCSD evaluation was 8.5 out of 10, with Spanish-speaking participants reporting a higher level of satisfaction compared to English-speaking participants Gazmararian, J., Elon, L., Yang, B., Graham, M., Parker, R. (2013). Text4baby Program: An Opportunity to Reach Underserved Pregnant and Postpartum Women? Maternal Child Health Journal. Abstract available: 2. Kaleka, A., Olsen, R., & Sweet, M. (2012, April 28). Utilization of Text4baby to Improve Maternal and Infant Outcomes with an Interdisciplinary Team.Seattle, Washington. Available: 3.California text4baby State University, San Marcos (2011). San Diego Researchers First to Report Positive Impact of Text4Baby Program [press release]. Retrieved from: Total sample size for first survey = 122.

24 Text4baby is Making an Impact

25 text4baby Medicaid Module

26 Flu Module 2013: Background & Module Design Education and Reminders: Beginning in October 2013, educational messages about the importance of the flu shot for pregnant women and mothers, as well as tailored education about flu shots for moms of infants >6 months who can be vaccinated, was sent to all Text4baby participants. All participants received a general reminder two weeks after they received the education message. Initial & general reminder messages were sent monthly to new enrollees through the end of flu season Partnership with Rite Aid: Participants (who enrolled prior to mid-dec) living in counties where a Rite Aid store is located also received a coupon offering for a free flu shot, redeemable at Rite Aid. Those who requested a coupon, received a reminder to use their coupon two weeks later, and in January before they expired. Flu education message Rite Aid Coupon Offer General Reminder Rite Aid Reminder Vaccination prevalence collection (Nov) Vaccination prevalence collection (Apr) text4baby

27 Text4baby in Michigan

28 Michigan Text4baby Outreach Highlights Promotion through a network of over 55 partners Michigan won the 2012 Text4baby State Enrollment Contest for the large state category by enrolling over 4,500 NEW moms into the service during the contest period (May- October 2012). MI Department of Community Health (MDCH) State-wide media campaign with radio and television ads. Presentations at meetings and conferences to engage new partners and providers. Addition of Text4baby to MI Healthy Baby mobile website and within Maternal Infant Health Program (MIHP). MI Primary Care Association (MPCA) Training staff on Text4baby. Integration of t4b enrollment into Medicaid/CHIP outreach activities. Digital engagement: Adding T4B enrollment button to website. text4baby 28

29 Best Practices for Outreach text4baby

30 Integrating into clinical practices: Neighborhood WIC & Text4baby In 2013, NYC WIC implemented in-depth training for all client-interacting staff, particularly focusing on Breastfeeding Peer Counselors. Strong emphasis on on-site enrollment and WICspecific appointment reminders with goal of increased WIC appointment adherence. Use of promotional materials: Flyers in waiting rooms, nutritionist s office, and displayed on digital screens in centers. Staff wear Ask me about Text4baby! pins. Digital promotion (website, social media). Media outreach to press, local leaders. By late 2013, 1200 women enrolled using WIC participant code in Neighborhood WIC counties. text4baby 30

31 Communicating directly with pregnant women and moms - Idaho Medicaid In September 2012, January 2013, and April, 2014 the Idaho Department of Health and Welfare & Idaho Medicaid sent a mailing about Text4baby to all pregnant women on Medicaid. The mailing resulted in a 3385% increase, a 953% increase, and a 2100% increase in enrollment, respectively, the week following the mailing. They subsequently scheduled mailings to new pregnant Medicaid enrollees every 6 months. text4baby

32 Using Media: North Carolina Television Public Service Announcements The above graph shows increased enrollment corresponding with PSA airings in the first two weeks of July users enrolled during July, compared to only 597 during June. This is an increase of over 200%. text4baby

33 Using Data to track promotional efforts Text4baby Enrollment by Zip Code Virginia Feb-Aug 2010 Smart Beginnings of Martinsville- Henry County in Martinsville, VA placed six Text4baby billboards in areas with high traffic. text4baby

34 Text4baby Partnership

35 Partner Benefits It s free! Resources available at including toolkits, tip sheets, boilerplate language, social media posts, press release templates, and more. Free promotional materials in English and Spanish. Technical assistance through HMHB. Access to logo and InDesign art files for materials customization. Access to zip code-level data to track local enrollment and monitor outreach strategies. Recognition and promotion on website and in Text4baby Tuesday, a weekly e-newsletter to thousands of partners. Receive program news and updates from national staff. Opportunity to be connected with peers for collaboration.

36 Help Enroll Moms-Signing up is Easy! 1) Text BABY to (BEBE for Spanish) 2) Follow prompt to enter due date or baby s DOB 3) Enter zip code 4) Receive FREE tips each week throughout pregnancy & until baby s 1 st birthday! 3 6

37 Other Important Information for Your Patients *Text4baby messages do not include any advertising or spam*

38 Enroll Patients through Web Enrollment Button In addition to SMS enrollment, women can sign up for Text4baby using If you have access to a computer, consider enrolling patients online during appointment. You can add the web enrollment button to your website and track visitors who enroll in Text4baby through your website.

39 Make it Easy to Promote Text4baby and Enroll Women Train patient-facing staff (scheduler, application assistant, and others) to sharetext4baby materials and encourage enrollment. Train visit schedulers about Text4baby s REMIND function to use Text4baby as an appointment reminder. Place the web enrollment button on your website. Can track enrollments that come from the button on your site Order FREE materials Include Text4baby materials in patient packets for pregnant women and families with infant under age 1. Display Text4baby materials on walls in waiting area, offices, and in other areas where flyers are displayed. Include Text4baby materials in educational classes, health fairs, and baby showers resource packets. Incorporate Text4baby information in to your ongoing Social Media efforts (i.e. Facebook, Twitter, etc.)

40 FREE Promotional Materials and Resources Available to Support your Efforts All promotional materials (available in English and Spanish) are shipped free of charge. Visit Text4baby.org to: Order materials. You will need to create a username and password to login. Download tip sheets, tool kits, videos, and other training materials.

41 Tools to Assist with Outreach Sort by partner type on You can access free: Tip sheets Factsheets Toolkits Brand standards Press release templates Social media posts Web enrollment button Examples of best practices

42 Access Real-time Data: Text4baby Enrollment Dashboard Partners can sign a Data Use Agreement to gain access to zip-code specific enrollment data DUA grants access to specific data fields to assist in developing outreach and marketing strategies and evaluating success Completed DUAs can be filled out and returned to Research Director, Jessica Bushar at jbushar@hmhb.org. 42

43 Q&A Thank you! Lindsay Handelsman Ohio Text4baby Senior Outreach Specialist